From Episodic to Real-Time Care in Diabetes Self-Management

糖尿病自我管理从间歇性护理到实时护理

• 批准号: 9095638
• 负责人: Ryan Jeffrey Shaw
• 金额: $ 47.69万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9095638
• 关键词: Accelerometer; Acute; Address; Algorithmic Software; Algorithms; Behavior; Blood Glucose; Caring; Chronic; Chronic Disease; Clinic; Clinical; Clinical Data; Collaborations; Computational algorithm; Data; Data Collection; Development; Devices; Diabetes Mellitus; Diagnosis; Diet; Disease; Emerging Technologies; Face; Feedback; Focus Groups; Fostering; Foundations; Health; Health Personnel; Health Professional; Health Status; Health Technology; Health behavior; Healthcare; Healthcare Systems; Individual; Interview; Knowledge; Leadership; Methods; Monitor; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Patients; Pharmaceutical Preparations; Physical activity; Primary Health Care; Provider; Psychosocial Influences; Self Management; Surveys; Text; Time; Weight; Wireless Technology; Work; Wrist; base; behavior change; care delivery; clinical care; data sharing; disorder control; dosage; efficacy testing; evidence base; fitbit; glucose monitor; improved; mHealth; medication compliance; meetings; mobile computing; mortality; patient subsets; personalized care; public health relevance; success; therapy development; tool

 DESCRIPTION (provided by applicant): Self-management is integral to control of type 2 diabetes mellitus (T2DM). Effective self-management however, requires real-time information on health status and behaviors and ongoing health professional facilitation of patients as they monitor and perform self-management. Accurate, timely information for these activities is notably absent from the current healthcare system. Providing real-time data would help patients and their care providers better understand illness dynamics, develop adaptive approaches to improve health outcomes, and deliver personalized care when and where it is most needed. Emerging mobile health technologies may facilitate adaptive self-management by patients with diabetes by capturing diabetes-related data and providing feedback to patients directly. Sharing these data in real-time with the patient and healthcare provider can foster collaborative work and change care delivery from infrequent episodic care delivery to real-time care at the point in time when patients need it most. However, to date we have little knowledge of how to support patients to use data from mobile technologies for real-time care and do not know how long patients will track multiple types of diabetes-related data. Moreover, we do not know what strategies will best help patients overcome self-management challenges using self-generated diabetes-related data or how providers might most effectively guide patients to better self-manage in real-time. We propose a mixed-methods exploratory study of 50 patients from a primary care clinic with a diagnosis of T2DM; they will be asked to track relevant clinical data over 6 months using a wireless body scale, phone-tethered glucometer, a wrist-worn accelerometer (i.e., Fitbit.), and a medication adherence text message survey. Data generated from the devices will be plotted as trajectories that will help us to understand the adaptive challenges that patients face in self-management. A subset of patients will be interviewed at monthly intervals over the 6 months to discuss their adaptive challenges and successes in diabetes self- management. Following the 6-month data collection period, we will conduct focus groups with providers to explore ways to address collaborative work to self-manage diabetes using self-monitoring data, and meet real- time challenges in diabetes self-management.

 描述（由适用提供）：自我管理对于2型糖尿病（T2DM）的控制是不可或缺的。然而，有效的自我管理需要有关健康状况和行为的实时信息以及患者监控和执行自我管理时持续的健康专业设施。当前的医疗保健系统明显没有针对这些活动的准确，及时的信息。提供实时数据将帮助患者及其护理提供者更好地了解疾病动态，开发适应性方法以改善健康结果，并在最需要的何时何地提供个性化的护理。新兴的移动健康技术可以通过捕获糖尿病相关数据并直接向患者提供反馈来促进糖尿病患者的适应性自我管理。与患者和医疗保健提供者实时共享这些数据可以促进协作工作，并在患者最需要的时间时，从不经常的情节护理提供到实时护理。但是，迄今为止，我们对如何支持患者使用移动技术数据进行实时护理的数据知之甚少，并且不知道患者会跟踪多种类型的糖尿病相关数据。此外，我们不知道哪些策略最能帮助患者使用与糖尿病相关的数据克服自我管理挑战，或者提供者如何最有效地指导患者实时更好地自我管理。我们提出了一项混合方法探索性研究，该研究对来自T2DM诊断的初级保健诊所的50名患者进行了探索性研究；他们将被要求使用无线身体尺度，电话螺旋式血糖仪，腕上磨损的加速度计（即Fitbit。）和药物依从性文本消息调查来跟踪相关的临床数据。从设备产生的数据将被绘制为轨迹，这将有助于我们了解患者在自我管理中面临的适应性挑战。在6个月中，将以每月的时间间隔对一部分患者进行采访，以讨论他们在糖尿病自我管理方面的适应性挑战和成功。在6个月的数据收集期之后，我们将与提供者进行焦点小组，以探索使用自我监控数据来解决自我管理糖尿病的协作工作的方法，并应对糖尿病自我管理的实时挑战。

项目成果

Diabetes Mobile Care: Aggregating and Visualizing Data from Multiple Mobile Health Technologies.

糖尿病移动护理：聚合和可视化来自多种移动医疗技术的数据。

• 发表时间: 2019
• 期刊: AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science
• 作者: Wood,Eleanor;Yang,Qing;Steinberg,Dori;Barnes,Angel;Vaughn,Jacqueline;Vorderstrasse,Allison;Crowley,Matthew;Henriquez,Craig;Streicher,Martin;BassBlue,Daniel;Choi,Susie;Shaw,RyanJ
• 通讯作者: Shaw,RyanJ